COFFEE REGIONAL MEDICAL CENTER
NPI 1366974263
Medicare Defined Swing Bed Unit in Douglas, GA

Q: What is Coffee Regional Medical Center, Inc's NPI number?

The NPI number for Coffee Regional Medical Center, Inc is 1366974263. It was assigned to this organization in the NPPES registry on March 30, 2017. The provider is doing business as Coffee Regional Medical Center.

Q: What is Coffee Regional Medical Center, Inc's specialty?

The primary specialty registered for this NPI is Medicare Defined Swing Bed Unit with taxonomy code 275N00000X.

Active since March 30, 2017CLIA 11D0646122 · Accreditation

1101 OCILLA RD, DOUGLAS, GA 31533(912) 384-1900 Get Directions Write a Review

NPPES record last updated: March 30, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Coffee Regional Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COFFEE REGIONAL MEDICAL CENTER (NPI 1366974263) is a healthcare organization registered as a medicare defined swing bed unit in Douglas, Georgia and active in the NPI registry since March 2017. The organization holds an CLIA Accreditation certificate valid through January 2, 2027 and lists Lavonda Cravey, Controller, as its authorized official.

NPPES Registry Identity

NPI1366974263

Entity TypeOrganization

Primary Taxonomy275N00000X

Legal Business NameCOFFEE REGIONAL MEDICAL CENTER, INC

Location Address1101 OCILLA RDDouglas, GA 31533-2207

Mailing Address1101 Ocilla RdDouglas, GA 31533-2207 · (912) 384-1900

Phone(912) 384-1900

Organization SubpartNo

Authorized OfficialLavonda CraveyController · (912) 384-1900

Enumeration DateMarch 30, 2017

✔ NPI 1366974263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMedicare Defined Swing Bed UnitHospital Units

Taxonomy Code275N00000X

License✔ Licensed in GA · 034-049

Definition

A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit.

1101 OCILLA RD, Douglas, GA 31533

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Other Names 1

Doing Business AsCoffee Regional Medical Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 11D0646122

Coffee Regional Medical Center · Douglas, GA

Active · expires Jan 2, 2027

CLIA Number11D0646122

Laboratory TypeHospital

Certificate Effective DateJanuary 3, 2025

Certificate Expiration DateJanuary 2, 2027

Laboratory DirectorDr. Gerson Paull

Laboratory Phone(912) 384-1900

Laboratory LocationCoffee Regional Medical Center1101 Ocilla Road, Douglas, GA 31533

CLIA data matches this NPI record on: Address Name Phone

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NIRANDR INTHACHAK M.D.

Radiology (Diagnostic Radiology)